Sample Essay: Duke School of Medicine

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Survivor of Anorexia; Emergency Medical Technician Training; Clinic Experience; Medical Volunteer in Honduras; HIV Test Counselor

I decided that I wanted to be a doctor sometime after my four month incarceration in Columbia Presbyterian Children's Hospital in the winter of 1986-87, as I struggled with anorexia nervosa. Through the maturation process that marked my recovery, I slowly came to realize that my pediatrician had saved my life-despite my valiant efforts to the contrary. Out of our individual stubborn wills was born a kind of mutual respect, and he is one of the people who make up my small collection of heroes.

I admire doctors who understand both what is said and what is held back, who move comfortably around the world of the body, and who treat all patients with respect. I am lucky because a few of them have become my impromptu teachers, taking a little extra time to instruct me in anatomy, disease or courtesy. During my Emergency Medical Technician training, one of the emergency room doctors took me to radiology to point out the shadow of a fracture in a CT-scan and trusted me to hold a little girl's lip while he inserted sutures. The physicians in the Hospital 12 de Octubre in Madrid, Spain taught me to hear lung sounds and to feel an enlarged liver and spleen. They explained the social and medical difficulties associated with the management of pediatric AIDS until I understood the Spanish well enough to begin asking questions; then they answered them.

I work now in the Mayfield Community Clinic, which provides primary care to members of the Spanish-speaking community near Stanford University. My job as a patient advocate involves taking histories, performing simple procedures and providing family planning and HIV counseling. I try to use the knowledge I have gained from class and practice to formulate the right set of questions to ask each patient, but I am constantly reminded of how much I have to learn. I look at a baby and notice its cute, pudgy toes. Dr. V. plays with it while conversing with its mother, and in less than a minute has noted its responsiveness, strength, and attachment to its parent, and checked its reflexes, color and hydration. Gingerly, I search for the tympanic membrane in the ears of a cooperative child and touch an infant's warm, soft belly, willing my hands to have a measure of Dr. V.'s competence.

I first felt the need to be competent regarding the human body when I volunteered with the Amigos de Las Americas program in the town of T. in Lempira, Honduras. The hospital available to the people of T. (at a day's ride in the bed of a truck) was "where one went to die," so my partner and I, with our basic first aid certifications and our $15 Johnson & Johnson kits, quickly became makeshift "doctors". The responsibility initially created a heady feeling; a distressed mother called on us to bandage the toe her eight-year-old son had accidentally sliced to the bone with his machete. I told him the story of Beauty and the Beast in broken Spanish while my partner and I soaked the dirt from his toe, and during the following week we watched him heal.

Then our foster-mother, who normally tended to the sick, told my partner and me to "check on the foot" of D. The gentle-eyed, sixty-five year old man lay on his bed, his leg encased in bloody bandages from mid-calf to toe. After performing surgery, the hospital had given him a bottle of injectable antibiotics and some clean needles and sent him home without bandages or further instructions. My partner and I had not been trained to handle so serious a situation. We did not know what had happened; we did not know what the antibiotics were (or if they were actually antibiotics); we did not know if handling D.'s blood put us at risk for disease. We wanted to leave, but leaving the house meant leaving D. and betraying our foster-mother's trust. So we injected the antibiotics and cleaned and bandaged the wound every day for our remaining two weeks in Honduras although we felt ill-equipped for the responsibility, crippled by our ignorance and lack of supplies.

In T., I did not feel qualified to receive the trust the townspeople gave so willingly. As an HIV-antibody test counselor in California, I struggle everyday to win my clients' confidence. Somehow a twenty-one-year-old, Caucasian female must be sincere, knowledgeable and open enough to earn the respect of a fifty-five-year-old man who could be her father, a high school sophomore, an ex-drug addict, and a pregnant Latina woman. My clients are black, white, straight, gay, Ph.D. candidates and illiterate; some choose to come to me while others have court-orders. Yet to communicate effectively, each client must have enough confidence in me to engage in dialogue about his drug or sex life and to believe what I tell him, whether or not he chooses to act on our discussion.

Speaking with patients, doctors and community members has opened my eyes to some of the difficulties involved with healthcare provision, and I hope I have given some inspiration or comfort in exchange for the knowledge I have received. I want these lessons in openness and compassion to shape my understanding of medicine and allow me to become the type of doctor I admire.

Note: This essay appears unedited for instructional purposes. Essays edited by EssayEdge are substantially improved.